Pilonidal sinus disease

Pilonidal sinus disease is an acute or chronic infection in the natal cleft, which may lead to formation of an abscess.

Pilonidal sinus disease can be diagnosed on examination; clinical investigations (eg imaging, blood tests) are not required.

Patients with asymptomatic pilonidal sinus disease do not require treatment.

Patients who present with a pilonidal abscess require urgent surgery—seek expert advice from a surgeon. Antibiotics may be used as an adjunct to surgery; however, they are not indicated unless cellulitis is present, and therapy should be guided by the results of cultures and susceptibility testing.